Chen Xianmeng, Wei Wei, Cao Jie, Hu Xiaowen, Ryu Jay Hoon
Department of Pulmonary and Critical Care Medicine.
Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China.
Medicine (Baltimore). 2020 Nov 20;99(47):e23319. doi: 10.1097/MD.0000000000023319.
An ongoing outbreak of Coronavirus Disease 2019 (COVID-19) has spread around the world. However, the clinical characteristics and outcomes of patients with COVID-19 related to different modes of exposure have not been well defined. We aimed to explore the clinical features and outcomes of COVID-19 related to one-time community exposure versus continuous household exposure.Retrospective case-control study involving COVID-19 patients admitted to a tertiary designated center in China was performed. Patients were enrolled if they had known exposure history of one-time community exposure or continuous household exposure. Twenty patients were compared in terms of demographic characteristics, clinical presentation, chest CT images, laboratory results, treatments, and clinical outcomes at 1-month follow-up.There were 10 patients in one-time community and continuous household exposure groups respectively. Males compromised 80% and 40% while the median ages were 37.5 and 51 years old in the 2 groups, respectively. Fever and cough were most common symptoms. Ground-glass opacities were presented on chest CT scan in 90% and 70% of the patients, and the median CT scores were 7 and 16 on admission, respectively. Three patients ranked severe in the community exposure group while 7 patients were severe or critical in household exposure group. On 1-month follow-up, all patients were improved clinically but COVID-19 IgG antibody detected positive. Median follow-up CT scores were 0 and 13 while pulmonary function test abnormalities were 0/9 and 2/7 in the 2 groups, respectively.COVID-19 patients with one-time community exposure tended to be mild in severity and had better outcomes, comparing to those with continuous household exposure.
2019年冠状病毒病（COVID-19）的持续爆发已蔓延至全球。然而，与不同暴露方式相关的COVID-19患者的临床特征和结局尚未明确界定。我们旨在探讨与一次性社区暴露和持续性家庭暴露相关的COVID-19的临床特征和结局。
对入住中国一家三级指定中心的COVID-19患者进行了回顾性病例对照研究。如果患者有一次性社区暴露或持续性家庭暴露的已知暴露史，则纳入研究。比较了20例患者的人口统计学特征、临床表现、胸部CT图像、实验室检查结果、治疗情况以及1个月随访时的临床结局。
一次性社区暴露组和持续性家庭暴露组各有患者10例。两组男性分别占80%和40%，中位年龄分别为37.5岁和51岁。发热和咳嗽是最常见的症状。胸部CT扫描显示，两组患者分别有90%和70%出现磨玻璃影，入院时CT评分中位数分别为7分和16分。社区暴露组有3例患者病情严重，而家庭暴露组有7例患者病情严重或危急。在1个月随访时，所有患者临床症状均有改善，但COVID-19 IgG抗体检测呈阳性。两组随访时CT评分中位数分别为0分和13分，肺功能测试异常情况分别为0/9和2/7。
与持续性家庭暴露的COVID-19患者相比，一次性社区暴露的患者病情往往较轻，结局较好。
